Marshall University Research Corporation (Marshall) focused its RROE project on the five southernmost coalfield counties in West Virginia, which cover 2,058 square miles and are located entirely in Appalachia. Marshall led the development of the Southern West Virginia Rural Opioid Planning Consortium, which brings together local QRTs, health departments, law enforcement assisted diversion programs, treatment providers, and other key stakeholders in monthly meetings. The QRTs made contact with 1,819 individuals and gave out 4,766 Narcan kits in 2021 and 2022. Marshall also developed a network of peer recovery support specialist support groups to assist these workers and hosted a conference, with nearly 100 attendees, that focused on training, collaboration, and best practices to address SUD.